It is currently developing a new, super hospital - Midland Metropolitan - to serve the 530,000 people living in Sandwell and West Birmingham. It is set to open in 2018.

A whistleblower last night broke ranks to say: “Morale is at rock bottom. Our concern is for patients and the ancillary services which rely on the trust.

“This is something the public should know about. We were informed the process will be done gradually, but there is real concern among staff.”

The trust has declined to give numbers, but a weekly bulletin to employees states: “Where there is scope to change we now need to press ahead and do so.

“In effect, we will address head on how we will improve outcomes for more patients, over the next five years, with around (by 2020) 1400 fewer posts -– and cut infection, improve mortality, better connect the care of people with long term conditions.”

Statistics underline the trust’s key role in the life of local residents.

Over the last 12 months, it has overseen 5,586 births, 564,395 people attended outpatient clinics and 176,496 casualties attended the two A&Es.

The trust is looking to identify £125 million worth of “efficiencies

”.

The bulk of savings will be made by cutting back on agency and temporary workers and it is believed large-scale redundancies can be avoided.

A statement confirmed: “Over the next three months, we will continue to review our workforce to identify where we can make changes and what we can learn from other NHS organisations.

“This period will include the necessary statutory consultation with staff and trade unions as we alter staffing levels in a minority of teams.

“We spend £25 million each year on temporary staff. We have sickness rates of over four per cent. One in ten employees changes role each year. These three things provide an opportunity to reduce costs without large scale redundancies and to improve the quality of care that we provide by creating stable teams.”